HomeMy WebLinkAboutA__Master_Land_Use_Application_Form_260401_v1CITY OF RENTON |PERMIT SERVICES
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
Name:Amani Imran and Rimi Afroze PHONE:206-391-1871
MAILING ADDRESS:212 Chelan Ave NE,Renton,WA 98059 EMAIL:amani.ewig@gmail.com
referto receive all correspondence via US mail.
APPLICANT(if other than owner)
NAME:Amani Imran and Rimi Afroze COMPANY(if applicable):
PHONE:206-391-1871 EMAIL:amani.ewig@gmail.com
MAILING ADDRESS:212 Chelan Ave NE,Renton,WA 98059
|||prefer to receive all correspondencevia US mail.
CONTACT PERSON
NAME:Amani Imran COMPANY(if applicable):
PHONE:206-391-1871 EMAIL:amani.ewig@gmail.com
MAILING ADDRESS:212 Chelan Ave NE,Renton,WA 98059
||prefer to receive all correspondencevia US mail.
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:Imran Short Plat
PROJECT/ADDRESS(ES)AND PARCEL NUMBERS:4612 NE 1st Street,Renton,WA 98059
EXISTING LAND USE(S):Single Family PROPOSEDLAND USE(S):Single Family
EXISTING COMPREHENSIVE PLAN MAPDESIGNATION:Residential moderate-density
PROPOSED COMPREHENSIVE PLAN MAPDESIGNATION (if applicable):N/A
EXISTING ZONING:R-8 PROPOSED ZONING:N/A
SITE AREA(in square feet):34,174 Square feet
SQUARE FOOTAGE OF PUBLIC ROADWAYSTO BE DEDICATED:O
PROPOSED RESIDENTIALDENSITY IN UNITS PER NET ACRE(if applicable):5 81 11
NUMBEROF PROPOSEDLOTS(if applicable):4
NUMBER OF NEW DWELLING UNITS(if applicable):5
NUMBEROFEXISTING DWELLING UNITS(if applicable):4 PROJECT VALUE:2 9 Million
SQUARE FOOTAGEOF PROPOSED RESIDENTIALBUILDINGS(if applicable):N/A
SQUARE FOOTAGEOF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable):1,260 Square feet
rentonwa.gov/permitservices |planningcustomerservice@rentonwa.gov |425-430-7294 12/10/2025 |Page 1 of 2
LAND USE PERMIT MASTER APPLICATION
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIALBUILDINGS(if applicable):N/A
SQUARE FOOTAGEOF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (if applicable):N/A
NET FLOOR AREA ON NON-RESIDENTIALBUILDINGS(if applicable):N/A
NUMBEROF EMPLOYEESTO BE EMPLOYED BY THE NEW PROJECT(if applicable):N/A.
IS THE SITE LOCATED IN ANY TYPE OF ENVIRONMENTALLYCRITICAL AREA,PLEASE INCLUDE SQUAREFOOTAGE(if applicable):
AQUIFER PROTECTION AREA ONE AQUIFER PROTECTION AREA TWO
P FLOOD HAZARD AREA SQ.FT |SHORELINE STREAMS &LAKES SQ.FT.
fC]GEOLOGIC HAZARD SQ.FT.[|WETLANDS SQ.FT.
|HABITAT CONSERVATION SQ.FT.
LEGAL DESCRIPTION OF PROPERTY
(Attach legal argeription on separate sheet with the following information included)SITUATE
IN THE N WW QUARTEROF SECTION 5 E ,TOWNSHIPINNWW,RANGE IG-2%Sw.
THE CITY OF RENTON,KING COUNTY,WASHINGTON
AFFIDAVIT OF OWNERSHI}/
|,(Print Name/s)Amony MIAN)hr,Geseunderpenalty of perjury under the lawsofthe State of
Washington that |am (please check‘one)current ownerof the property involved in this application or the
authorized representative to act for a corporation (please attach proof of authorization)and that the foregoing
statements and answers herein contained and the information herewith are in all respects true and correct to the best
of my knowlgdg¢and belief.YN...AoeBaifeozeRainsOF:opfsifr£
aSignatureof Owner/Representative Date Signature of Owner/Representative Date
STATE OF WASHINGTON)
)ss
COUNTY OF KING )
|certify that |know or havesatisfactory evidence that Pinas Toapn *Bind.Mvroze signed this instrument and
acknowledgeit to be his/her/their free and voluntary act for the uses and purpose mentionedin the instrument.
3181226 =
Dated Notary Public |in and for the State of Washington
TARANKIRAT SINGH Veja t biedt’_&Lahn
Notary Public Notary (Print):
State of WashingtonCommission#207903MyComm.Expires Apr 21,2027
My appointment expires:df./d }1.“7
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